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M <br /> �J �- S = oo a <br /> Z N y O N 0 <br /> M - —� °o o c0i <br /> C/) ONoZi m <br /> M rt g 5022 C) n <br /> Dov 0 <br /> I o <br /> bate run'.10!28!2020 O <br /> -�P?"''- 3Hr4 jLjAkUUIN LLVUN I V E•.r+r orison a5 oT i0728f2020 N)co <br /> o" <br /> Mr (D <br /> Facility lnfonratlon for CERS GomP o <br /> Moxa channesrcartections In RE ink. CP W <br /> 7 <br /> Q <br /> �• <br /> v <br /> N <br /> 1:31 CA 93215 co <br /> 0 2355 RD. 192 [)ELAN S61 725-0654 0 <br /> p 863 08$$, FAX( ) o <br /> Job Site : Ph.:(209) rn <br /> N I(2 46-0727047 CAI-0003670a <br /> GENERATOR Llc,AND INSURED TRANSPORTER 0 346 n �' <br /> Site EPA ILl# Q 3 Invoice No. M L <br /> LU <br /> 7 <br /> Contact Person BILI TO <br /> t m <br /> Company Name Name <br /> Address l Address <br /> City,stale.Zip (Q <br /> Driv r Truck] arae o <br /> Site Phone 0 <br /> ! Customer PO Interval N,e �^o ]GasttlGh 0 <br /> Oafe }� `['J' � <br /> ��-7!J�� Quantity Units Price Amount <br /> waste CAM �} <br /> PRODUCT "1 �6 Gal l✓ % � <br /> Non-RCRA Hazardous Waste Liquid tUsed.Oil) 221 Gal <br /> Non-RCRA Hazardous Waste Liquid(Oil&Water) 223 Gal <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 133 <br /> Non.RCRA Hazardous Waste Solids Contaminated f)cum[s) <br /> Non-RCRA Hazardous Waste SDlids Contaminated with Used Oil <br /> 4rums[s� <br /> Drained Used Oil Friter Drum(s) Fath Z'S� p <br /> Empty Drum(s) HR. <br /> Transportation&Truck Time&Washout <br /> Hazardous Testing <br /> we pay❑ Customer Pays <br /> Sota4 <br /> UNess otherwise specitied on Ihls onsolldated Manifest Receipt(Invoice)Terms:Accounts due on the 1 oth of the month following <br /> month of purchase.Past due accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1.5%per month,which Is the <br /> ANNUAL PERCENTAGE RATE OF 18%, <br /> I hereby certify that f have not mixed this waste with any other waste that the total halides are less than 1000 PPM,and that the PPM,total h or co waste dnY <br /> a PCB's n <br /> any PCB's.I fu her gree to accept the a ditional charges for legal disposal If this,waste Is over <br /> GENERATOR o DRIVER SIGNATURE <br /> AUTHORIZED <br /> TERMS:1NVOI E OVER 30 AY BJ %SERVICE CHARGE CUSTOMER AGREED TO PAY ALL LE AL FEES OF COU <br /> ACTION BECOMES NECES ARYTO COLLECT THIS INVOICE. <br /> aKerr Oil here pplicable to maadvis the above Generator that nagement of used oil.but that is not requlared totors hcomplytw with the moreof used all astringentrequiirrements apd to a plicable to that Is required <br /> hazardous aste managemen with fede�al. taclGties. <br /> Kern oil f=ilter Recycling is authorized to No a request for EPA#from DISC.California facilities that handle or process used oil are required to meet those more <br /> stringent requirements,and some out-of-state facilities that process used oil&also meetthose requirements,engineering certifications of tank integrity,and financial o <br /> assurances for closure an accidental releases.it Is lawful to send used oil to out-of-state faculties that comply only with federal used oil management standards and Cn <br /> not those more stringent requirements By signing the invoice the generator certifies that the generator has established a program to reduce the volume of quantity <br /> and toxicity of the hazardous waste to the degree,as determined by generator,to be economically practicable.By both parties signing this Invoice it WM serve as an w <br /> agreoment thatKern Oil will submit confirmations for(certain waste streams)to the generator that thelrwaste has been transported to a iicenced treatment or ttansfer <br /> facility <br /> ❑ ❑ NAME <br /> California Oil Transfer ❑ anADDRESS <br /> 5300 Claus Rd,Bldg 11 1620 E Brundage Ln CITY <br /> Modesto,CA 95357 Bakersfield,CA 93307 O <br /> Ph:209-663.5181 CAL000282598 STATE,ZIP Q <br /> Fax;209-863-8171 PHONE D <br /> EPA#CALOG0190616 EPA ID <br /> m <br /> Cn <br /> o <br /> v � <br />